Personality Of The Therapist Or Guide

Numerous observations made during clinical research with LSD strongly suggest that the personalities of the therapist, the co-therapist, the sitters, or any persons present are factors of paramount significance in structuring the content, course, and outcome of psychedelic sessions. Probably the single most important element determining the nature of an LSD experience is the feeling of safety and trust on the part of the experient. This is, of course, critically dependent on the presence or absence of the guide, his or her personal characteristics, and the nature of the relationship between the subject and this person. It is absolutely essential for the successful course and outcome of an LSD session that the subject lets go of his or her usual defenses and surrenders to the psychedelic process. This usually requires the possibility of relegating the reality testing and all the decisions on practical matters to a trusted sitter.

A person taking a psychedelic drug alone cannot really fully abandon control at the crucial moments of the experience, because a part of him or her has to continue playing the role of the reality-oriented judge and sitter. However, total surrender is absolutely essential for completing the experience of ego death, one of , the crucial steps in the LSD process. Certain important problems that originated ( in interpersonal situations, such as difficulties with basic trust, can also not be suc-/ cessfully resolved and overcome without the human element providing a correc-1 tive emotional experience. I have repeatedly seen in the early stages of our therapeutic work with LSD,5 when the role of the sitter was not sufficiently understood, that patients were not able to overcome certain recurrent impasses in their LSD sessions until the therapist promised to stay with them through the entire experience and never leave the room.

If psychedelic sessions are conducted for therapeutic purposes, the emotional significance of the therapist for the patient has two distinct components. The first one is based on the reality of the patient's actual life-situation at the time of therapy and reflects the fact that the therapist is a person who is supposed to provide help with crippling emotional symptoms and the difficulties of living. The investment of time and energy, as well as the financial commitment necessary for treatment, further accentuate the intensity of the patient's emotional involvement. The second component of the therapeutic relationship is its transference aspect. In LSD therapy this element is generally much more powerful than in conventional psychotherapy, and tends to increase with the number of LSD sessions until the time it is resolved. It is based on the fact that the patients, in the course of long-term psychotherapeutic interaction in the sessions and outside of them, project on the therapist a variety of strong emotional attitudes derived from important figures of their past and present life, especially close family members. Although there exist techniques which can minimize the transference problems during the free intervals between psychedelic sessions, this element plays an important role at the time of the drug effect. It is not unusual for the actions of the therapist to have a far-reaching influence on the content and course of the sessions. At certain periods of the psychedelic experience, LSD subjects can show unusually strong reactions to the therapists' leaving or entering the room, offering or withdrawing physical contact, or to seemingly indifferent gestures and comments. Occasionally, even such phenomena as the colors of optical illusions and visions, or intense physical symptoms such as severe nausea and vomiting, suffocation, agonizing pain and cardiac distress, can change dramatically as a result of the therapist's behavior, intervention, or interpretations.

The importance of the therapist as a powerful determinant of the session increases considerably if LSD is administered after a long period of systematic intensive psychotherapy or if the drug is given repeatedly within the framework of a psycholytic series. In that case, it is not uncommon for the transference phenomena to play a dominant role in the manifest content of an entire session.6

The degree of human and professional interest of the therapist, his or her clinical experience and therapeutic skill, personal security, freedom from anxiety, and current physical and mental condition are very important factors in successful LSD therapy. It is absolutely essential that, prior to the administration of LSD, the therapist examine his or her own motivation and attitudes toward the subject, try to establish a good working relationship, arid clarify the transference-counter-transference situation. The therapist should never offer LSD as an impressive and "magical" procedure to a patient who is stagnating in psychotherapy, just because he or she can not tolerate the atmosphere of failure, insecurity, or helplessness. Another objectionable approach is to administer the drug to a patient who has been neglected for a long time because of personal or objective reasons, in order to compensate for these circumstances and create a feeling that something important is going on. Perhaps the most dangerous motivation for using LSD is the need to demonstrate power and authority to a troublesome patient who is shattering the therapist's sense of security. All these and similar problems, if not properly analyzed, can easily contaminate the LSD session, especially if they happen to replicate traumatic experiences in the patient's past.

Clarity in the relationship between the therapist and the subject is a necessary prerequisite for a successful course of therapy. As we mentioned earlier, LSD can best be described as an amplifier of mental processes. By activating the intrapsychic elements in the subject, it also amplifies the interpersonal situation between him or herself and other people present in the session. This makes it possible to see the transference aspects of the relationship clearly and thus view also the nature of the maladjustive interpersonal patterns of the patient. If the situation between the therapist and the patient is clear and open, this becomes a great opportunity for therapeutic progress. However, if there are overt or covert misunderstandings, conflicts and distortions in the therapeutic relationship before the session, they can be exaggerated by the drug-cffect to such a degree that they become a serious impasse and eventually endanger the treatment process. It is important therefore that the guide be aware during the sessions of his or her own intrapsychic and interpersonal patterns, so that they do not interfere with the psychedelic process.

All the phenomena in LSD sessions that involve the subject, the sitters, and their mutual relationships, are the result of a complicated interaction between the specific personality characteristics of each of them. The proportion of the individual contributions varies from situation to situation and session to session. However, since the mental processes of LSD subjects are powerfully activated by the drug, they usually play a more important role in determining the content and nature of such interactions unless some very serious countertransference problems are involved on the part of the sitters.

The degree of the transference distortion seems to be related to the dosage and to the nature of the unconscious material that is emerging in the session. In periods in which the subject is under the influence of the drug but is not dealing with any difficult emotional material, he or she can show unusual depth and clarity of perception. The ability for intuitive and empathic understanding of others can be sharpened and deepened to a startling degree. In some instances, LSD subjects can make amazingly accurate readings of the sitters even at a time \Vhen they are struggling with emotional problems of various kinds. This happens when the nature of the problems they are facing is similar to or identical with problematic areas in the sitters. A deep exploration of certain unconscious structures within oneself can thus mediate an instant intuitive understanding of corresponding elements in others.

In these situations, the personalities of the sitters, their thought-processes, emotional reactions, attitudes and behavior patterns become especially important. We have repeatedly observed that LSD subjects to tune into the inner feelings of the sitters with great accuracy. They were able to tell when the therapist was fully concentrated, dedicated to the session, and pleased with its course or, conversely, distracted by other professional or personal problems, bored, tired, dissatisfied with the course of the session, or worried about its unfavorable development. This is quite understandable in those cases where the LSD subject can see the sitters' facial expressions. It is conceivable that the effect of the drug can sensitize an individual to various minor or even subliminal clues to the point where these would provide adequate information and sufficient feedback for accurate reading. This could happen even in those cases where the phenomena involved were so subtle that under the conditions of conventional psychotherapy they would escape the patient's conscious attention. However, in some instances where this happened the subjects had their eyes closed or covered by eyeshades; in others, their eyes were open but they were not facing the therapist.

It is also important to add that the subject's and the therapist's concepts of what constitutes a "good" and productive session do not necessarily coincide, especially at the time it is still underway. Therefore it is not possible for the LSD

subject to guess the therapist's feelings about the session automatically from his or her own evaluation. In some instances, the ability of the subjects to "read" the therapist correctly was truly striking and seemed to border on genuine extrasensory perception. Some patients correctly guessed not only the therapist's emotional tones, but also the specific content of his thought-processes, or they felt connectcd with his memory system and accurately described certain concrete circumstances and recent or remote events from his life.

Elements of accurate perception are more common in low-dose sessions, in which the amount of LSD is not sufficient to activate important emotional material. In high-dose sessions they occur by and large, at the beginning, before the subject's experiential field is occupied by the emerging unconscious contents, or later, after the difficult aspects of the experience have been worked through and resolved. However, this is not an absolute rule and there exist significant exceptions; episodes of unusual clarity occasionally occur at any dosage level and at any time during the session. They seem to be associated with the nature of the experience or a particular state of mind, rather than a specific time of the drug reaction or its intensity. When LSD subjects are deeply engaged in their problem areas, most of their perceptions, thoughts, feelings and anticipations concerning the sitters have very little substantiation in reality. They are projections, reflecting the subject's inner experiences—his or her emotions, instinctual tendencies, and superego functions.

In high-dose LSD sessions a good therapeutic relationship is an element of critical importance. It is necessary to emphasize that even an ideal interpersonal situation cannot completely prevent the occurrence of significant distortions under the influence of the drug. However, if there is a clear and solid relationship between the experient and the sitters outside of the session context, the drug-induced distortions become an important opportunity for learning and for corrective emotional experiences, rather than a danger to the psychedelic process. A good therapeutic relationship helps the patient to let go of psychological defenses, surrender to the experience, and endure the difficult periods of sessions characterized by intense physical and emotional suffering or confusion. The quality of the therapeutic relationship is essential for working through one of the most crucial situations in psychedelic therapy, the crisis of basic trust.

As long as the guide does not significantly contribute to the interpersonal configuration on a reality basis, in terms of strong countertransference, the subject's LSD experiences concerning the therapeutic situation reflect the nature of the emerging unconscious material. There exist many different forms and degrees of projective distortion in the therapeutic relationship. The most superficial and simple manifestation of this kind is fantasizing or visualizing the therapist as assuming certain specific opinions and attitudes. If this occurs at a time when the subject has eye contact with the therapist, it can take the form of actual illusive transformations of the facial expression. Thus the patient may see the therapist as chuckling, smiling and laughing, or expressing condescension, irony and ridicule. He or she might find clear indications of sexual interest or even arousal in the therapist's face and signs of seductiveness in his gestures. The therapist can appear to be critical, angry, hateful and aggressive, or emanate compassion, understanding and love. His face may appear to betray uncertainty, concern, fear, or guilt feelings. The nature of fantasies and transformations of this kind reflects the variety of feelings and attitudes that the subject transfers onto the therapist. Quite frequently, the projections take a much more elaborate and intricate form; in the extreme, this can result in complex illusive transformations of the therapist's face, body image, and attire. Sometimes the symbolic meaning of such changes is immediately clear and obvious; at other times their full understanding requires systematic and focused analytical work.

There are several typical categories of problems reflected in these symbolic transformations. The most common are those images that represent projections oj the subject's instinctual tendencies oj an aggressive or sexual nature. Thus the therapist can be illusively transformed into various figures representing violence, cruelty and sadism. Here belong, for example, representatives of professions such as a butcher, boxer, executioner, mercenary, or inquisitor; infamous historical figures like Genghis Khan, Caesar Nero, Voivod Dracula, Hitler, or Stalin; and an entire gallery of murderers, hired guns, robbers, SS and Gestapo members, red commissars, head-hunting savages, and others. Famous characters from horror movies also occur frequently in this context, exemplified by Frankenstein, The Créature from the Black Lagoon, Dracula, King Kong, and Godzilla. Another manifestation of the subject's aggression is the symbolic transformation of the therapist into a bloodthirsty predator—eagle, lion, tiger, black panther, jaguar, shark, or tyrannosaurus. A similar meaning can be associated with the therapist changing into one of the traditional adversaries of such animals—a gladiator, hunter, or tamer of wild beasts. Archetypal images symbolizing aggression are equally common; they range from evil magicians, malicious witches, and vampires to devils, demons, and devouring deities. A subject tuned into aggressive themes in his or her own unconscious may see the treatment room transformed into the cabinet of Dr. Caligari, a dungeon, torture chamber, barrack in a concentration camp, or a death cell. Innocent objects in the therapist's hand, such as a pencil, fountain pen, or a piece of paper, change into daggers, hatchets, saws, guns, and other murderous tools.

In the same way, sexual tendencies can be manifested in the form of symbolic projections. The therapist is perceived as an Oriental harem owner, a lewd lecher, prostitute, suburban pimp, metropolitan swinger, or a frivolous and promiscuous bohemian painter. Don Juan, Rasputin, Poppea, Casanova, and Hugh Hefner were some other sexual symbols observed in this context. linages that express sexual attractidn without a pejorative undertone range from famous film stars and legendary romantic lovers to archetypal gods of love.In advanced LSD sessions deified personifications of the male and female principles such as the Apollo-Aphrodite or Shiva-Shakti dyad occur frequently, and images of priests or priestesses in various love cults, fertility rites, phallic worship, or tribal rituals involving sexuality are also quite common. Oil several occasions, transformation of the therapist's visage into the/"leonine face" of a leper or the deformed face of a syphilitic could be deciphered as a projection of sexual wishes combined with the threat of punishment.

Another typical category of illusive transformations involves projections oj the subject's Superego. The therapist is frequently perceived as various specific personages who evaluate, judge, or criticize the experient. These can be parental figures, teachers and other critical authorities from the subject's life, priests, judges and jury members, various archetypal personifications of Justice, and even

Three representations of illusory transformation of the therapist, lie appears as an Arabian merchant dealing with dangerous intoxicating drugs (above left): a wild and primitive African native (left); and as an Indian sage radiating perennial wisdom (above right). Kadi image reflected the nature and content of the patient's psychedelic experience at that particular time.

Illusory transformation of the therapist. Here he becomes a sadistic monster who enjoys inflicting suffering on the patient. The angelic figure on the left represents the patient's awareness that the tortures will ultimately lead to a spiritual opening. The castle on the right reflects his vague awareness of a medieval scene of torture which he felt as a karmic memory. The experience occurred during a session characterized by the transition from

God or the Devil. Some other visions seem to reflect the part of the subject's Superego that represents the ego ideal. The therapist is then perceived as being an absolutely perfect human, a person endowed with all imaginable virtues, possessing iiiitl having achieved all that the patient always wanted—physical beauty, moral integrity, superior intelligence, emotional stability, and a balanced life situation.

A typical category of transformations reflects the subject's s Iron a nerd for unconditional love and undivided attention, as well as irritation at not having exclusive possession and control of tile therapist. This is most characteristic of psychodynamic sessions that involve deep regression to early infancy and intense anaclitic needs. Many patients find it difficult to accept the fact that they have to share tile therapist with other patients, that the therapist has a private life of his or her own, or that the therapeutic framework sets certain clear limits on intimacy. Whether the objective reality justifies it or not, many patients feel they are being treated with professional coolncss and scientific objectivity, or as experimental guinea pigs. Even if physical contact is used in the sessions, a client sensitive in this area may experience it as a therapeutic technique or a professional ploy rather than a genuine expression of human affection.

The therapist's curiosity concerning the patient's history or the dynamics of his or her problems can in this context be ridiculed by an illusive change of the therapist into Sherlock Holmes, Hercule Poirot, Leon Clifton, or just a caricature of a detective with a large pipe, spectacles, and a magnifying glass. Ilis professional, objective and "scientific" approach to the patient can be caricatured in an illusive transformation into a funny-looking, learned owl, sitting on a pile of cobweb-covered volumes. The irritating lack of adequate emotional response and professional "coolness" can be reflected in a visual illusion showing him in the thick protective suit of a medieval armored knight, astronaut, fireman, or scuba-diver. The recording of the session may irritate the patient, even if he or she not only agreed to it before the session, but specifically requested it. It can be ridiculed by a satirical vision of the therapist as a pliilistine bureaucrat, ambitious and diligent schoolboy, or provincial clerk. The white coat, a common symbol of the physician, can play an important part in this context; the medical role of the therapist can be attacked by changing him into representatives of other professions w ho also use white coats, such as grocers, barbers, or butchers. Transformations of the therapist into Doctor Faust, observed in the past, were deciphered as allusions to his sophistication and title, the unconventional nature of his scientific quest, and the magical properties of the drug he uses; in some instances they also reflected the wish that he follow Faust's example and exchange science for mundane pleasure.7

A very interesting, cartoon-like illustration of some of these problems occurred in one of the early sessions of Agnes, who was undergoing psycho-lytic treatment for a severe chronic neurosis. In the phase of therapy when she desperately wanted the therapist for herself and was jealous of all the other patients, she experienced in her LSD session symbolic sequences from a chicken hatchery, which represented a satire on her LSD treatment. The hatchery symbolized the Psychiatric Research Institute where she was in therapy and her co-patients appeared as eggs with various flaws and defects

Illusory transformation of the therapist into a nosy dctcctive with a large pipe ("Sherlock Holmes"). The patient is depicting his irritation with the therapist's inquisitiveness and objectivity.

Illusory transformation of the therapist into a nosy dctcctive with a large pipe ("Sherlock Holmes"). The patient is depicting his irritation with the therapist's inquisitiveness and objectivity.

that were in different stages of hatching. Since the experience of birth is an important therapeutic step in LSD therapy, hatching symbolized in this context the successful end of treatment and the cure of neurosis. The patient-eggs were competing with each other, trying to expedite the hatching process, but also to win the affection of the therapist. The latter was represented by a system of electric bulbs providing scientifically measured amounts of light and warmth. The patient herself was a dissatisfied little chicken embryo who passionately competed for the artificial heat, since that was all that was available. In reality, she wanted to be the single offspring of a real mother hen and could not put up with the electric surrogate.

As indicated by this example, the transformation of the therapist does not have to occur as an isolated phenomenon, but can be accompanied by simultaneous autosymbolic transformation of the patient and/or illusive change of the entire environment.

Like most LSD phenomena, the illusive transformation of the guide and the environment usually has a multi-level and ovcrdetermined structure. Although one specific meaning or connection may be in the center of awareness, one can usually find a number of additional functions for the same image. As in the case of dreams, there frequently exist several interpretations for the same phenomenon. They involve material from different levels of the unconscious and, quite typically, opposing tendencies and emotions can find joint representation in a single condensed symbolic image. Although we have thus far been discussing visual manifestations, which are the most striking, projective distortions can involve other senses, such as hearing, smell, taste, and touch.

The concrete content of the illusive transformations reflects the type of the LSD experience and the level of the unconscious that is activated. The most superficial changes are of an abstract nature and do not seem to have any deeper symbolic significance. The therapist's face can appear undulating, distorted, or in changing colors. On occasion, his or her skin is covered with mosaics and intricate geometrical designs that look like tattoos or aboriginal decorations. These changes resemble the disturbances on the screen of a television set that is out of tune and seem to reflect chemical stimulation of the sensory apparatus.

On the psychodynamic level, the illusive transformations reflect the basic themes of individual COEX systems colored by the specific content of the layer that is at that time in the center of the experiential field. The therapist can be perceived as a parental figure, sibling, close relative, nanny, neighbor, or any significant person who was instrumental in important childhood experiences. Doctors and nurses who conducted painful medical interventions, acquaintances who played the roles of surrogate parents, adults who physically or sexually abused the subject, and protagonists in various frightful episodes are typical representatives of this category. Occasionally, the therapist may assume the form of favorite animals, such as the family dog, pet rabbit or hen, or even an emotionally important children's toy which was the subject's surrogate companion.

Sometimes the projective transformations do not directly reflect the biographical events recorded in a COEX system, but variations on its central theme. The following example from an LSD session of Renata,8 a patient who suffered from severe cancerophobia, shows how even a seemingly insignificant partial transformation of the therapist can condense relevant material from different levels.

When Renata looked at the therapist, the light reflection in his eye took the form of a large Sphinx moth. Free associations which Renata volunteered the next day brought out the following material:

The Sphinx is a night moth that visits flowers with intoxicating fragrance and sucks the nectar from them. It has a distinct mark of a human

A Sphinx moth seen in the therapist's eye.

skull on its back and is usually associated in folklore with death. This reflects a theme which was very important for Renata and formed the basis of her cancerophobia. As a result of certain childhood experiences, particularly sexual abuse by her stepfather at the age of eight, sex and death were intimately connected in her unconscious. Summer nights and heavy sweet fragrance suggest the atmosphere of romance and love-making; the Sphinx flying around is a portent of death.

Some additional associations showed the complicated, overdetermined, and ingenious structure underlying this transformation. Renata read somewhere that the Sphinx caterpillars live on Atropa Belladonna or the deadly nightshade, which is known for its psychoactive properties and was used in medieval potions and ointments for the Witches' Sabbath. Small doses of Belladonna are hallucinogenic and larger doses extremely toxic. The hallucinogenic properties of Belladonna represent a link to the LSD process. Its relation to the orgies of the Witches' Sabbath alludes to dangerous aspects of sex. Its connection with death, beside reemphasizing the closeness between sex and death, also points back to the LSD process which has the death experience as an important element. Renata also remembered reading somewhere that the Sphinx caterpillars sleep in an erect position. She found a direct link from here to the traumatic situation of seduction by her stepfather during which she was confronted with his penis.

On the deepest level the name of the Sphinx moth pointed to the Egyptian Sphinx. This image of the destructive female—a creature with a human head and animal body, which strangles its victims-—occurs frequently in LSD sessions dealing with the agony of birth and transcendence. It was on the perinatal level, in the process of biological birth, that Renata found the deepest unconscious roots of the fusion and confusion in her between sex and death.

The transformations of the therapist in sessions with strong perinatal emphasis have a very different quality. The general direction of the projective change depends on the stage of the death-rebirth process, or the basic perinatal matrix which is activated at that time.

The basic elements and attributes associated with each of the matrices are characteristic and quite distinct. For BPM I it is transcendental beauty, unconditional love, merging of boundaries, an atmosphere of numinosity, and a sense of nourishment and protection. The very beginning of BPM II involves deep metaphysical fear, feelings of threat and paranoia, and a sense of losing autonomy. A fully developed BPM II is characterized by an atmosphere of irreversible entrapment, hopeless victimization, experience of endless, diabolical tortures and loss of one's soul. BPM III imparts the elements of a titanic and bloody fight with sadomasochistic, sexual, and scatological features. The transition from BPM III to BPM IV is experienced as an overwhelming pressure to surrender completely and unconditionally, abysmal fear of annihilation, and expectations of catastrophe. BPM IV then has the unmistakable quality of spiritual liberation, deliverance from darkness, salvation, and illumination.

If the subject is under the influence of one of the negative perinatal matrices, the therapist can appear as a representative of elements and movements that threaten not only individuals but the entire world: the chief of a dangerous underground organization, a representative of an extraterrestrial civilization trying to enslave mankind, an important Nazi or Communist leader, a misguided religious fanatic, a mad-genius scientist, or the Devil himself. Confronted with these images, the subject can lose the critical insight that he or she is involved in a symbolic process and experience a full-blown paranoid reaction. In more superficial and less convincing experiences, a number of specific elements of perinatal symbolism can be projected onto the therapist; he can change into a mythological monster threatening to devour the subject, the Great Inquisitor, the commandant of a concentration camp, or a diabolic sadist. He or she can change into various historical figures known for their cruelty, sexual perverts, copro-philiacs, warriors, severely sick or wounded persons, conquistadors, Pre-Columbian priests, carnival figures, or crucified Christ. The specific form of these transformations depends on the stage of the death-rebirth process, the level on which1 it is experienced, and the passive or active role of the subject.

When the positive matrices dominate the LSD session, the transformations have a very different quality. If it is BPM IV, the therapist can be perceived as a triumphant military leader celebrating victory over a vicious enemy, the Savior, the embodiment of cosmic wisdom, a teacher of the deepest secrets of life and nature, a manifestation of the divine principle, or essentially God. The activation of BPM I has many of the elements of BPM IV, such as the radiance, sacredness, and humor; however, these have a timeless quality instead of occurring as a stage in the process of transition from death to rebirth. The subject can experience loss of boundaries and a feeling of fundamental oneness with the therapist, associated with a sense of absolute safety and total nourishment.

Quite frequently during the death-rebirth process, the therapist assumes for the subject the role of the delivering mother and may actually be experienced as such; this can occur with both male and female sitters without regard to the actual sex identity. Under these circumstances the transference relationship can assume a symbiotic quality; it is characterized by a deep biologically rooted ambivalence, and its relevance is so basic that it appears to be a matter of life and death. The therapist can become for the patient a magical and powerful figure of cosmic proportions. The patient can have either a sense of participating in this power or of being in a totally passive, dependent and vulnerable position. A critical factor in this situation seems to be the patient's ability to trust the world and human beings, which essentially reflects his or her early history. The nature of the childhood ex-i perience determines whether a totally dependent role can be enjoyed or whether it • becomes a source of vital threat and paranoid ideation.

Frequently the patient has to go through a profound crisis of basic trust to be able to reconnect with the nourishing aspects of the mother-child relationship. When the early symbiotic situation of the perinatal period is projected on the therapist, LSD patients often lose the ability to differentiate clearly between the therapist and themselves. Their perceptions, emotions and thoughts seem to merge with those of the therapist. This can result in a feeling of being magically influenced or controlled by suggestion, hypnosis, telepathy, or even psychokinesis. The therapist appears to read their minds and know all their thoughts; the opposite is also common, namely, the sense of having access to the therapist's mind and sha'r-ing his feelings or thought-processes. Under these circumstances patients frequently find it unnecessary to communicate their experiences verbally. They feel either that the therapist automatically shares and knows the experience in all its details, or that he has prearranged it and controls it, so that everything is happening according to his plan. In critical stages of the death-rebirth process the therapist can become the murderous or life-giving womb, and can also be experienced as the delivering obstetrician or midwife. This is especially frequent if the treatment technique involves actual physical contact and support.

The problems in the transference relationship on the perinatal level culminate when the patient is approaching the moment of ego death, which coincides Ij with reliving the moment of biological birth. This involves totally letting go of all ijl defenses, all effective control, and all reference points, and is typically associated 1 with a profound crisis of basic trust. In this state of ultimate vulnerability the patient questions the character and motives of the therapist in an attempt to assess the degree of danger in total surrender. Important negative aspects of the patient's history emerge in an amplified form and are projected onto the therapist in various symbolic manifestations. In addition, the real flaws in the therapist's personality, attitudes and motives, and the problems and conflicts in the therapeutic relationship, are seen as if through a magnifying glass. The patient's perception of the therapist can be-a reflection of his or her experience in the murderous birth canal, and the LSD process can appear at this point as a diabolic scheme to destroy the patients, brainwash them, enslave them for eternity, or steal their souls.

After the crisis of trust has been worked through and the bond of confidence re-established, the transference phenomena tend to swing to the other extreme. A subject influenced by BPM I or IV can see the therapist as the ultimate source of love, security, and nourishment. He or she can experience the therapist as being the good breast and the good womb at the same time. There do not seem to be any more individual boundaries, only a continuous, free flow of thoughts, emotions, and good energy. The patient experiences this as the ultimate process of nursing, in which the milk seems to be coming from a spiritual source and has miraculous healing properties. The same experience also seems to have embryonal qualities; the circulation of different kinds of spiritual emotions and energies seems to have strong elements of the placentary exchange between the mother and child. Once this biological, emotional and spiritual link is established, the therapist can be perceived not only as one's own mother, but as the good mother in general—the archetypal image of the Great Mother, Mother Nature, and ultimately the entire cosmos or God.

In LSD sessions of a transpersonal nature, the transference relationship has a completely different quality. The illusive transformations of the therapist can no longer be interpreted in the same way as those on the psychodynamic level—as complicated symbolic images with a multilevel and overdetermined structure, or as projections reflecting various layers of the COEX systems. These illusive transformations also differ from the perinatal transference phenomena, which can be understood as repetitions of the nourishing and destructive aspects of the symbiotic relationship with the mother. Transpersonal projections are phenomena that sui generis defy further psychological analysis.

In general, almost all of the many types of transpersonal experiences can find specific reflections in the therapeutic relationship. Thus the therapist can assume the forms of powerful archetypal images, such as sacralized representatives of various roles, or deities and demons. The transformations into the Cosmic Man, the Wise Man, the Great Hermaphrodite, the Animus or Anima, Shiva, Kali, Ganesha, Zeus, Venus, Apollo, Satan, Isis, Cybele, or Coatlicue, would be examples in this category. Equally frequent are transformations of the therapist into a great religious teacher—Jesus, Moses, Mohammed, Buddha, Sri Ramana Maharishi, and others. When the patient is experiencing elements of the racial and collective unconscious, the therapist may be transformed into a representative of another culture and/or a person existing in a different century. Such an episode can also have a "past-incarnation experiential quality." In that case, the patients feel convinced that they are reliving memories from their past lives and that the present situation is a replica or variation of an event that occurred in the remote past. It is quite common for clients to feel that they have met the therapist in many of their previous incarnations. Occasionally, this can involve very complex situations from different cultures and centuries which may be visualized in considerable detail.

Inclusion of the therapist into ancestral or phylogenetic memories occurs quite frequently. In that case the therapist appears transformed into a specific human or animal ancestor of the same or opposite sex. In general, the projective transformations of the therapist on the transpersonal level are quite different from those of a basically psychodynamic, Freudian nature. The former feel very genuine, authentic and convincing; they frequently contain valid and objectively verifiable information that seems to go far beyond the subject's educational background and level of information. Unlike the projective transformations on the

* psychodynamic level, they cannot be deciphered and interpreted as symbolic representations of certain aspects of the patient's present existence. Even those ■ patients who enthusiastically help to analyze various projective phenomena on the \ psychodynamic level refuse the Freudian approach to the transpersonal realm as superficial, inadequate, and inappropriate.

The enormous significance of the therapist or sitter during the LSD sessions has its consequences for psychotherapeutic practice. On the one hand, the role frequently presents serious problems for the therapist, who may come under emotional pressures of various kinds and has to guard against all the intricate pitfalls of the transference and countertransference situation. On the other hand, the intensification of the therapeutic relationship goes far beyond the limits of conventional psychotherapy, frequently reaching the point of caricature. This makes it easier for the patient and therapist to recognize and understand the transference nature of the problems involved. To an experienced therapist, the dimensions of jl the therapeutic relationship reached in psychedelic sessions offer a unique oppor-l tunity to mediate powerful corrective emotional experiences on very deep levels | that are not easy to reach by conventional psychotherapy.

To be able to face all the challenges of psychedelic therapy, the therapist has to have special training that involves personal experiences with the drug. Because of the extraordinary nature of the LSD states and the limitations of our language in describing them, it is impossible for the future LSD therapist to acquire deeper ^ understanding of the process without first-hand exposure. Reading about psychedelic experiences, attending seminars and lectures, or even witnessing sessions of other people can Only convey a superficial and inadequate knowledge. Personal sessions have another important function: they offer an opportunity to work through one's own areas of conflict and problems on various levels. Some of the crucial issues that a future LSD therapist has to confront remain essentially untouched in most forms of conventional therapy. Fear of death, total loss of control, and the specter of insanity can be mentioned here as salient examples. Unless the therapist deals successfully with these issues, the manifestations of the deep unconscious of the patient will tend to activate his or her own problem areas and trigger difficult emotional and psychosomatic responses. This can be conducive to serious transference-countertransference problems and places increased demands on the defense system and self-control. LSD sessions in which the therapist has to struggle with his or her unresolved problems can become a real burden; they are usually experienced as mutually draining and result in excessive fatigue.

Other important qualities and abilities of a good LSD therapist come from long clinical experience. With the increase in the number of sessions that he or she has witnessed, the therapist becomes more comfortable with and less threatened by various unusual phenomena that are quite common in psychedelic therapy. In everyday practice he or she observes a great number of people suffering through i dramatic experiences of dying, going crazy and feeling possessed by evil spirits, or ' claiming that they went beyond the point of no return. Witnessing positive resolutions of such states and seeing the same subjects only a few hours later radiant and joking, the therapist gradually develops equanimity, confidence and tolerance in regard to the entire spectrum of psychedelic phenomena. This attitude is transferred onto the patients and makes it possible for them to allow themselves to experience whatever is emerging in the LSD sessions in order to find the roots of their emotional problems.

Continue reading here: Set And Setting Of The Sessions

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